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| Title |
No Evidence To Compare Polymerization Shrinkage And Sensitivity With Incremental-Fill vs. Bulk-Fill Composites |
| Clinical Question |
Do composites that are bulk-fill, such as SonicFill™, have excessive polymerization shrinkage causing sensitivity, when compared to incremental-fill composites? |
| Clinical Bottom Line |
At this time, there are no studies that have been conducted using a bulk-fill composite such as Sonicfill™ to test polymerization shrinkage or sensitivity. In general, when traditional composites are used in a bulk-fill fashion, they appear to have decreased hardness and increased amounts of polymerization shrinkage when compared to incremental-filling. Using data on the SonicFill™ website, there is nothing to suggest a unique category of polymerization shrinkage exists for it compared to older composites where polymerization shrinkage is significant when used in bulk-fill. The delivery method is unique, but there is no data to suggest that the shrinkage problems in the studies cited would be overcome by altering the delivery. More studies need to be conducted using the newer types of bulk-fill composites. |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 17692594 | Lazarchik/2007 | 70 recently extracted human molars | In vitro Randomized Control Trial | | Key results | For 3 multi-shaded materials tested, axial hardness values were relatively unaffected by composite resin shade or filler classification for the incremental technique, but were significantly affected by these factors when using the bulk-fill method. A single shade translucent material was not affected in either the bulk or incremental condition. | | #2) 18433857 | Park/2008 | 15 aluminum blocks prepared for MOD restorations | Comparative study of aluminum blocks | | Key results | The bulk filling technique yielded significantly more cuspal deflection than the incremental filling techniques, while there was no significant difference between the horizontal and oblique increment methods. | |
| Evidence Search |
"incremental and bulk filled technique" AND "composite" |
Comments on
The Evidence |
Neither study was performed in vivo and the second study was performed on aluminum blocks rather than actual teeth. Unfortunately, there is no evidence for composites developed to be used in a bulk-fill fashion. |
| Applicability |
The results from these studies are relevant when using more traditional composites. |
| Specialty/Discipline |
(General Dentistry) (Restorative Dentistry) |
| Keywords |
composite resin, incremental filling technique, bulk fill technique, polymerization shrinkage, sensitivity
|
| ID# |
2140 |
| Date of submission: |
09/16/2011 |
| E-mail |
normans@livemail.uthscsa.edu |
| Author |
Sarah Norman |
| Co-author(s) |
|
| Co-author(s) e-mail |
|
| Faculty mentor/Co-author |
David Cox, DDS |
| Faculty mentor/Co-author e-mail |
CoxD@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Juan Verastegui (San Antonio, TX) on 11/30/2017
A PubMed search in Nov. 2017, located a lab study that provides a more conclusive answer to the CAT clinical question, using extracted molars with MOD preparations. Rosatto et al. (PMID# 26449641) examined physical properties of bulk-fill composites compared to incremental filling composite techniques. Outcome measures also included shrinkage stress, cuspal strain and fracture resistance. Results indicate that bulk-fill composite techniques resulted in lower cusp strain, shrinkage stress and higher fracture resistance. | |
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